U.S. is not an Ebola-free island

Reading through Newsweek magazine this week, there was an article about the television, radio and newspaper topic of the day: Ebola.

It is not surprising that this week's Newsweek would run a story that has everyone conjecturing and talking. The story was titled "Ebola by the Numbers: Poverty and War Fueled This Outbreak," and began with a quote from Sierra Leone's president, who said, "What is required is required yesterday." He might as well be talking about a good deal of Africa.

Ebola is on the top of the list of everyone's concerns, and it should be. It is not the first time that a disease has appeared and terrified the populous of where it began. It also is scaring those of us who reside in the U.S. I remember well the days of AIDS (before the name of HIV) when people were afraid to go to Haiti and where huge areas of Africa were affected. The hysteria got so great that HIV-infected doctors were kicked out of practicing in hospitals, and people were concerned that restaurants they went to might have had someone with HIV handling the food.

I am not suggesting that Ebola is HIV. Clearly, Ebola is much more lethal. The lethality is huge, but the greater issue is how we can prevent various viruses that we might not even know about from taking hold in the future. Surely, even if we are able to develop a cure or vaccine for Ebola, another virus will be emerging soon after.

Newsweek's article had a chart illustrating the numbers and expenditures in the three major countries that are having the Ebola outbreak. The list makes clear the need for health-care infrastructure: 0.04 percent of adult Americans have no education; in Liberia, 56 percent have no education, and in Sierra Leone 65 percent do not. Guinea spent 6 percent of its gross domestic product, or GDP, on health care; 17.2 is what the U.S. spends. Life expectancy in the U.S. is 79 years; in Sierra Leone it is 45, and in Liberia it is 60 years. Worse is the under age 5 mortality rate, which in Guinea is 123 out of 100,000 births and in Sierra Leone, 193. Those without proper toilets in the U.S. cities are 0 percent, and those in Sierra Leone and Liberia range from 23-28 percent. I don't think you need to be a trained health-care professional to know that the results of these kind of health-care statistics can create trouble.

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Reading the Newsweek article, I began to reflect on what would happen if the Ebola crises moved east and somehow South Sudan were to have it cross its borders. It has been in Sudan (when it was one country between North and South) with the first outbreak in 1976. Although it has not reached what is now South Sudan, the figures do not portend well for being able to handle the virus. Life expectancy is higher than Sierra Leone, but at 54.6 years it is not in the comfort zone for being a healthy country. Although health spending has varied by year, it is about 5 percent of GDP, which is less than any current Ebola country. Proper sanitation is crucial to controlling outbreaks, and roughly 41 percent of people in South Sudan do not have access to a toilet. That is indeed a scary figure where Ebola and other diseases can spread as a direct result of poor sanitation. Capping off a big public health problem is the literacy rate, which is thought to be only 20 percent in the entire country.

Ebola might be contained. It might not reach South Sudan, but something will come along and will be found in South Sudan and other places where the infrastructure is as poor as South Sudan. This is the problem we are seeing now in Ebola countries. Many Americans do not believe we should put money in Africa. They have said, "We have enough problems in our own country."

They're right, but as we are seeing with Ebola, contagious disease does not know boundaries. Ebola does not carry a map of the world in its genome. We must begin to help countries develop the sanitation, medical and education infrastructure that can respond to new and emerging threats. It is not just pure altruism that should lead us to help these countries. We do not live on an island, and we must improve other parts of the world before yet another virus/disease emerges that we can't control.

To again quote the president of Sierra Leone, "What is required is required yesterday."

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